OBJECTIVE: To optimize the formulation of ambroxol hydrochloride sandwich osmotic pump tablets using Box-Behnken design response surface method. METHODS: Firstly, significant factors, including amount of glucose, ratio of pore former to weight of coating, and thicknesss of coating, were chosen carefully by single-factor methods, then Box-Behnken design-response surface method was adopted to understand the effects of these factors on the drug release by using similarity factor f2 as evaluation index. And multiple linear regression model and quadratic polynomial equation were established to evaluate the relationship between these factors and similarity factor f2. Secondly, the permeation mechanism of sandwich osmotic pump was studied carefully by SEM and drug release behavior investigation. RESULTS: The quadratic polynomial equation was ideal to fit the prediction result of drug release; the optimal formulation according to Design-Expert8.0.5 software was established as follows: 50 mg of glucose, 8% of pore former, 9% of coating weight. The f2 was approximate 89.33 compared with ideal drug release curve, which was relatively close to the model-predicted f2 value (88.89). Through investigation of permeation mechanism, it was found that the drug release from this delivery system was driven by osmotic pressure difference between the interior of tablets and the release medium. By means of SEM observation, it was shown that some pores on the coating surface were produced after drug release in the medium, but few before drug release, which cued that a lot of medium got into the interior of tablets through the tunnels formed by the porogen in the coating. CONCLUSION: Box-Behnken design method can be used to optimize the formulation of sandwich osmotic pump tablets.

Objective To investigate the incidence of pregnancy complicated with myelodys- plastic syndrome(MDS)and the influence between pregnancy and MDS and to discuss the diagnosis, treatment and prognosis of pregnancy complicated with MDS.Methods Six pregnant patients complicated with MDS from Jan,1992 to Dec,1997 were retrospectively analysed and literature was reviewed.Results The incidence of pregnancy complicated with MDS was 0.66‰ and 24% of women with MDS were pregnant women.Therapeutic induction of labor was done in 2 cases because of severe MDS.Two complicated with PIH,and three complicated with postpartum haemorrage in six cases.Blood transfusion was necessary in all cases for treatment of severe anemia in pregnancy. MDS may remit after delivery.The use of corticosteroid before termination of pregnancy and prophy- lactic antibiotics after delivery is important.Conclusions It is important to prevent haemorrage and infection in the management of pregnaney complicated with MDS.

Objective To study the feasibility of transumbilical single-incision laparoscopic surgery ( SILS) in the treatment of tubal pregnancy, as compared with conventional multi-port laparoscopic surgery. Methods Sixty-two patients diagnosed as tubal pregnancy undergoing laparoscopic surgery at this hospital between September 2013 and June 2014 were selected for investigation. There were 29 cases of transumbilical SILS ( SILS group) and 33 cases of conventional multi-port laparoscopic surgery ( MPLS group) . We retrospectively reviewed the medical records of all patients and analyzed the surgical outcomes, including operative time, blood loss, surgical complications and hospital stay. Results In both groups, all procedures were performed without failure.No conversion to open surgery or additional skin incision was needed.There were no differences between the SILS and MPLS groups in the operation time [(51.5 ±10.8) min vs.(47.3 ±9.4) min, t=1.637, P=0.107], the mean estimated blood loss [(15.5 ±10.5) ml vs.(18.4 ±12.2) ml, t=-0.996, P=0.323], the absolute decrease of hemoglobin from preoperative to postoperative [(14 ± 5) g/L vs.(13 ±4) g/L, t=0.874, P=0.386], the postoperative hospital stay [(3.5 ±0.9) d vs.(3.8 ±0.8) d, t=-1.390, P=0.170], and the incidence of postoperative fever (2 cases vs.3 cases, χ2 =0.000, P=1.000).Follow-up for 1-3 months ( mean, 1.8 months) in all the cases showed smooth recovery and no postoperative complications. Conclusion SILS is a feasible and safe approach in the treatment of tubal pregnancy.

OBJECTIVE: To select excipients and optimize preparation for the ambroxol hydrochloride/levosalbutamol sulfate dry powder inhalation. METHODS: Drug and different excipients in the same ratio were prepared by spray drying to obtain a certain particle size as drug particles or carriers for dry powder inhalation, respectively. Study and compare the parameters of powders of the dry powder inhaler, such as the angle of repose, moisture content, and emptying rate, etc, to screen the excipient of the vectors. Afterward, Box-Behnken design method was adopted to optimize of preparation parameters. RESULTS: When lactose-high branched cyclodextrin compounds were used as composite carriers, their powder properties meet the requirements of dry powder inhaler, such as the repose angle was 39.69 degrees, the bulk density was 0.37 g·mL-1, the tap density was 0.66 g·mL-1, the evacuation rate of drug-carrier powders in capsules was 93.12%, and the water content was 0.10% and the simulated lung deposition rate was 14.63%. The preparation parameters, such as sample concentration, inlet air temperature, nozzle diameter parameters, theirs values were 50 mg·mL-1, 110℃, 1 mm, respectively, were opmized by Box-Behnken design method, which could obtain the carrier particle size of 30.33 μm. CONCLUSION: Lactose-high branched cyclodextrin complexes can be used as carrier for levosalbutamol sulfate-ambroxol hydrochloride compound dry powder inhaler, which could meet the requirements of dry powder inhaler by spray-drying preparation method.

Objective To evaluate the accuracy and sensitivity of three techniques in the diagnosis of renal diseases following multiple myeloma. Methods 41 serum samples from the kidney-damaged patients with multiple myeloma and 36 from the control group with general renal diseases were detected by quantitative analysis of immunoglobulins, serum protein electrophoresis and serum Immunofixation Electrophoresis. The accuracy and sensitivity of the three techniques were analysed by Two-way ANOVA and Multiple Comparisons of the check-out rate of monoclonal immunoglobulin. Results No monoclonal components were checked out by quantitative analysis of immunoglobulins. The checkout rate of IgG and IgM myelomas were 100% by serum protein electrophoresis, which had application limit on other types of myelomas. Whereas all secretarial myelomas could be diagnosed and typied by Immunofixation Electrophoresis, the sensitivity and accuracy was 100%, there was no false positive in the control group. Comparing with quantitative analysis of immunoglobulins and serum protein electrophoresis, serum Immunofixation electrophoresis had higher sensitivity and accuracy in diagnosis of renal diseases following multiple myeloma ( P

Objective To investigate the effects and the possible mechanisms of nerve growth factor (NGF) on serum levels of vascular endothelial growth factor (VEGF) and stromal cell-derived factor 1 (SDF-1) protein expression in rats with focal cerebral ischemia.Methods Male Sprague-Dawley rats weighting 200 ～ 250 g were subjected to middle cerebral occlusion (MCAO).MCAO rats were randomly divided into NGF group,saline control group and NGF+PI3K antagonist group (n =12).The neurological function was evaluated on the 4th,7th day after MCAO,and the serum levels of VEGF and SDF-1 protein were measured by ELISA.Results The neurological function was better in rats of the NGF group than those of the saline control group and NGF+PI3K antagonist on the 4th,7th day after MCAO (P ＜ 0.05).The serum levels of VEGF and SDF-1 protein of the NGF group was significantly higher than that of the saline control group and NGF+PI3K antagonist group on the 4th day after MCAO (P ＜ 0.05).Conclusions Treatment with NGF may improve neurological function of rats with focal cerebral ischemia,and upregulate serum levels of VEGF and SDF-1 protein expression.PI3K/AKT signal pathway may have attended the above regulation.

Objective To investigate the use of feeding support and influencing factors of oral feeding among premature infants. Methods Totally 103 premature infants with oral feeding problems hospitalized during June to December 2014 were enrolled. The postmenstrual age and feeding support were observed at the time of initiation oral feeding and full oral feeding. Moreover, the progress and performance of oral feeding, the daily increase in weight, the time of body weight regain, the time of assisted ventilation and length of hospital stay and so on were calculated. Results There were 96 premature infants using feeding support at the time of initiation oral feeding and 58 premature infants at the time of full oral feeding. Logistic regression analysis showed that birth gestational age(OR=2.195, P<0.01), birth weight(OR=1.003, P<0.01), severity of illness(OR=0.121, P<0.01) and feeding tolerance(OR=0.007, P<0.01)were important factors of oral feeding among premature infants. Conclusions The premature infants with small gestational age at birth, low birth weight, severity of illness, and feeding intolerance are high risk populations of oral feeding. Nurses should take timely risk assessment and interventions to reduce the occurrence of stopping oral feeding.

Objective Research the correlation between expression of MMP-2 in colorectal cancer and patho- logical factors,or biological behaviors in colorectal cancer.Methods The expression of MMP-2 in 68 cases with col- orectal cancer were detected by immunohistochemical staining.Results The expression of MMP-2 in colorectal can- cer was not correlated with tumor region and histologic type,but related with depth of tumor invasion and metasta- sis.The frequency of positive cases in patients with colorectal cancer with of lymph,node metastasis was significantly higher than that in patients without lymph node metastasis(P

ObjectiveTo discuss the experimental method and the mechanisms on treating diseases by acupuncturing the ST36(Zusanli).MethodsUsing Positron Emission Tomography(PET) and functional Magnetic Resonance Imaging(fMRI) to obtain the experimental data about glycometabolism and cerebral blood stream,using SPM and ROI image-analytical method to obtain the visual experimental evidence when acupuncturing the ST36. ResultsThere are certain increases of glycometabolism and cerebral blood stream in ipsilateral hypothalamus and bilateral temporal lobe, when acupuncturing the ST36. Conclusions Acupuncturing the ST36 can lead to the functional changes in vegetative nerve center and temporal lobe, which is close correlated with the therapeutical effects of ST36.

Objective To evaluate the value of left ventricular energy loss (EL) in the systolic left ventricular hemodynamic changes in hypertensive patients by ultrasonic flow vector imaging (VFM). Methods Ninty-eight hypertensive patients were divided into non left ventricular hypertrophy group (NLVH group) and left ventricular hypertrophy group (LVH group) according to the left ventricular mass index(LVMI).Thirty-one healthy adults were erolled as control group.The average total energy loss (EL-T),basal energy loss (EL-B),middle energy loss (EL-M) and apical energy loss (EL-A) of each isovolumic contraction phase,fast ejection phase and slow ejection phase were obtained by VFM,the difference among the three groups were compared.Results ①EL-T and EL-B in isovolumic phase,rapid ejection phase and slow ejection phase in NLVH group were higher than those in control group ( P <0.05 or P <0.01);EL-T,EL-B,EL-M and EL-A in isovolumic phase,rapid ejection phase and slow ejection phase in LVH group were all higher than those in control group ( P <0.05 or P <0.01);EL-M in isovolumic phase and rapid ejection phase,EL-T,EL-B,EL-M and EL-A in slow ejection phase in LVH group were higher than those in the NLVH group ( P <0.05 or P <0.01).② There was a positive correlation between EL-T and LVMI (r=0.311, P < 0.01),EL-B and LVMI ( r = 0.219, P < 0.05),EL-M and LVMI( r = 0.207, P <0.05),EL-T and LVEF( r = 0.340, P < 0.05),EL-B and LVEF( r = 0.367, P < 0.01) in isovolumic contraction phase.There was a positive correlation between EL-B and LVEF( r = 0.359, P < 0.01) in rapid ejection phase.There was a positive relation between EL-B and LVEF( r =0.352,P <0.05) in slow ejection phase.Conclusions The EL of systolic peroid in hypertensive patients increased,which suggests that the left ventricular hemodynamic changes abnormally,VFM can accurately evaluate the changes of hemodynamic during systole.